This book is about the understanding and treatment of severe personality disorders. The essays contained in it are all original, having been written specifically for this volume. The thrust is essentially clinical and pragmatic, based on best practice, and, whenever possible, the best evidence. Eschewing biological, psychoanalytic and cognitive behavioral theories, the book focuses upon issues of day-to-day management of patients with severe personality disorder. The topics covered range from early predictors, treatability, common elements of effective therapies, psychopharmacological interventions, countertransference, disruptions of the therapeutic alliance, and suicidal crises, to the management of the dangerous, refractory, and stalking patient. The book is a collective effort by distinguished investigators and innovators in the field of severe personality disorders. A common link among them is that they all have been involved with “Psychiatrie in Progressie,” a postgraduate educational program of Zon and Schild, a Dutch psychiatric hospital, now part of the Symfora groep. The book is a tribute to Henk-Jan Dalewijk, who until 2005 was Executive Director of the Symfora groep. As a psychiatrist and administrator, he enabled the development of excellent teaching programs on psychiatry and psychotherapy, inspiring all the friends and colleagues who contributed to this volume.

The book comprises 13 chapters. In the first chapter, Michael H. Stone, an early researcher on the course and outcome of personality disorders, addresses one of the major issues of everyday practice: severity and treatability.